Objective To develop a value evaluation index system for health management and logistics positions in pub-lic hospitals,providing a research tool for future performance evaluations and salary reform.Methods Literature review,focus group interviews,and the point-factor method were employed to establish an initial index pool.A public hospital in Guangzhou was selected as a case study.Delphi expert consultation was then utilized to refine and finalize the indicators for the evaluation system.Results For the two rounds of Delphi expert consultation,the response rates were 87.5％and 100.0％,with the expert authority coefficient of 0.812.The Kendall's W coordination coefficients were 0.796 and 0.624 for the first round,and 0.747 and 0.918 for the second,(all＜0.001).The coefficients of variation ranged from 0.157 to 0.265 for the first round and from 0.108 to 0.230 for the second round.Experts provided four suggestions,leading to the removal of one secondary indicator and modifications to the definitions of three others.Finally,the evaluation system consists of 4 primary indicators and 12 secondary indicators.Conclusion This system can provide a research tool and reference for the follow-up performance evaluation,improve the salary reform of public hospitals,and promote the high-quality development of public hospitals.

Bruton's tyrosine kinase inhibitors (BTKi) are a class of novel small-molecule targeted antitumor drugs used to treat B-cell malignancies. However, safety issues associated with BTKi may lead to treatment interruption, compromising their efficacy. To promote the standardized management of safety in BTKi treatment, Evidence-Based Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society, Expert Committee on Lymphoma of Chinese Society of Clinical Oncology, Expert Committee on Leukemia of Chinese Society of Clinical Oncology, Integrated Cancer Cardiology Branch of China Anti-Cancer Association, Hematology Branch of the Chinese Medical Association, and Hospital Pharmacy Professional Committee of the Cross-Straits Medicine Exchange Association formulated the Evidence-based Expert Consensus on the Clinical Management of Safety of Bruton′s Tyrosine Kinase Inhibitors (2024), which was published in the Chinese Journal of Cancer Research in June 2024. It covered 9 clinical issues in the following 3 domains: (1) the management of common adverse reactions of BTKi such as bleeding, cardiovascular events, hematological toxicity, infections, rashes, diarrhea, and arthralgia; (2) the management of drug-drug interactions; (3) management guidance for special populations. This consensus provides evidence-based recommendations for the safety management of BTKi medication in clinical practice. This article provides an interpretation and evidence summary of the consensus in Chinese, aiming to facilitate its implementation in China, enhance the safety management of BTKi treatment, and improve patient outcomes.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

BACKGROUND:Deferoxamine exhibits multiple functions such as stem cell modulation,immune regulation,and promotion of angiogenesis and osteogenesis,but its role in the osteoinhibition induced by dexamethasone in osteoblasts remains unclear.OBJECTIVE:To investigate the effects of deferoxamine on osteoblasts treated with dexamethasone through the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway and to explore its potential mechanisms of action.METHODS:The proliferation of MC3T3-E1 cells treated with various concentrations of deferoxamine for 24,48,and 72 hours was assessed using the cell counting kit-8 assay to determine the optimal intervention concentration.There were control,dexamethasone,dexamethasone plus deferoxamine 10 μmol/L,and dexamethasone plus deferoxamine 20 μmol/L groups in the experiment.Cell counting kit-8 assay and flow cytometry were employed to evaluate the effect of deferoxamine on dexamethasone-induced cell proliferation and apoptosis.Alkaline phosphatase staining and activity assays were conducted to assess alkaline phosphatase levels in MC3T3-E1 cells.Alizarin red staining was used to observe the formation of mineralized nodules.Western blot was employed to detect the expression of osteogenic and signaling proteins.RESULTS AND CONCLUSION:(1)Deferoxamine showed no significant cytotoxicity to MC3T3-E1 cells within the range of 5-20 μmol/L and could ameliorate the inhibitory effects of dexamethasone on MC3T3-E1 cell proliferation and apoptosis.(2)Compared with the dexamethasone group,deferoxamine groups increased alkaline phosphatase activity and cell mineralization,and also significantly increased the protein expression of osteopontin,runt-related transcription factor 2,and alkaline phosphatase in MC3T3-E1 cells.(3)Deferoxamine also activated the hypoxia-inducible factor 1α/vascular endothelial growth factor pathway in dexamethasone-treated MC3T3-E1 cells.To conclude,deferoxamine can alleviate apoptosis in osteoblasts induced by dexamethasone treatment,maintain the vitality of osteoblasts by activating the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway,and promote their proliferation,which may help delay the progression of steroid-induced osteonecrosis of the femoral head.

Objective To evaluate the feasibility and clinical significance of the three-dimensional acetabular oval fossa-guided positioning technique in acetabular prosthesis placement during total hip arthroplasty(THA).Methods Sixty patients with femoral neck fractures who underwent primary THA were randomly divided into two groups(n=30 per group).The observation group received acetabular component placement guided by a three-dimensional positioning technique based on preoperative acetabular angle measurements and pelvic model reconstruction using CT data.During surgery,placement was performed according to the preoperative plan,using anatomical landmarks including the acetabular fossa,transverse acetabular incision,and transverse acetabular ligament.The control group underwent conventional freehand acetabular component placement.The two groups were compared in terms of surgical parameters(operation time,intraoperative fluoroscopy frequency,blood loss),postoperative deviations in acetabular component angles(abduction and anteversion angles),Harris hip score(HHS),visual analog scale(VAS)for pain,and dislocation rate.Results Baseline characteristics were comparable between groups.The observation group exhibited a slightly longer operation time and significantly greater blood loss compared to the control group,with no significant difference in fluoroscopy frequency.Postoperative radiographic measurements showed that deviations in both the abduction and anteversion angles of the acetabular component were significantly smaller in the observation group than in the control group.At one month postoperatively,the HHS was significantly higher and the VAS score was significantly lower in the observation group.However,no significant differences in functional or pain scores were found between the two groups at three and six months postoperatively.No dislocations were observed in the observation group,whereas one dislocation occurred in the control group.Conclusions The three-dimensional acetabulum oval fossa-guided positioning technique,which integrates anatomical landmarks with individualized preoperative planning,enables precise quantitative measurement and significantly enhances the accuracy of acetabular component placement angles in THA.This improvement contributes to faster postoperative functional recovery and leads to favorable clinical outcomes,demonstrating strong practical application value.

Objective To evaluate the feasibility and clinical significance of the three-dimensional acetabular oval fossa-guided positioning technique in acetabular prosthesis placement during total hip arthroplasty(THA).Methods Sixty patients with femoral neck fractures who underwent primary THA were randomly divided into two groups(n=30 per group).The observation group received acetabular component placement guided by a three-dimensional positioning technique based on preoperative acetabular angle measurements and pelvic model reconstruction using CT data.During surgery,placement was performed according to the preoperative plan,using anatomical landmarks including the acetabular fossa,transverse acetabular incision,and transverse acetabular ligament.The control group underwent conventional freehand acetabular component placement.The two groups were compared in terms of surgical parameters(operation time,intraoperative fluoroscopy frequency,blood loss),postoperative deviations in acetabular component angles(abduction and anteversion angles),Harris hip score(HHS),visual analog scale(VAS)for pain,and dislocation rate.Results Baseline characteristics were comparable between groups.The observation group exhibited a slightly longer operation time and significantly greater blood loss compared to the control group,with no significant difference in fluoroscopy frequency.Postoperative radiographic measurements showed that deviations in both the abduction and anteversion angles of the acetabular component were significantly smaller in the observation group than in the control group.At one month postoperatively,the HHS was significantly higher and the VAS score was significantly lower in the observation group.However,no significant differences in functional or pain scores were found between the two groups at three and six months postoperatively.No dislocations were observed in the observation group,whereas one dislocation occurred in the control group.Conclusions The three-dimensional acetabulum oval fossa-guided positioning technique,which integrates anatomical landmarks with individualized preoperative planning,enables precise quantitative measurement and significantly enhances the accuracy of acetabular component placement angles in THA.This improvement contributes to faster postoperative functional recovery and leads to favorable clinical outcomes,demonstrating strong practical application value.

Objective To develop a value evaluation index system for health management and logistics positions in pub-lic hospitals,providing a research tool for future performance evaluations and salary reform.Methods Literature review,focus group interviews,and the point-factor method were employed to establish an initial index pool.A public hospital in Guangzhou was selected as a case study.Delphi expert consultation was then utilized to refine and finalize the indicators for the evaluation system.Results For the two rounds of Delphi expert consultation,the response rates were 87.5％and 100.0％,with the expert authority coefficient of 0.812.The Kendall's W coordination coefficients were 0.796 and 0.624 for the first round,and 0.747 and 0.918 for the second,(all＜0.001).The coefficients of variation ranged from 0.157 to 0.265 for the first round and from 0.108 to 0.230 for the second round.Experts provided four suggestions,leading to the removal of one secondary indicator and modifications to the definitions of three others.Finally,the evaluation system consists of 4 primary indicators and 12 secondary indicators.Conclusion This system can provide a research tool and reference for the follow-up performance evaluation,improve the salary reform of public hospitals,and promote the high-quality development of public hospitals.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Bruton's tyrosine kinase inhibitors (BTKi) are a class of novel small-molecule targeted antitumor drugs used to treat B-cell malignancies. However, safety issues associated with BTKi may lead to treatment interruption, compromising their efficacy. To promote the standardized management of safety in BTKi treatment, Evidence-Based Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society, Expert Committee on Lymphoma of Chinese Society of Clinical Oncology, Expert Committee on Leukemia of Chinese Society of Clinical Oncology, Integrated Cancer Cardiology Branch of China Anti-Cancer Association, Hematology Branch of the Chinese Medical Association, and Hospital Pharmacy Professional Committee of the Cross-Straits Medicine Exchange Association formulated the Evidence-based Expert Consensus on the Clinical Management of Safety of Bruton′s Tyrosine Kinase Inhibitors (2024), which was published in the Chinese Journal of Cancer Research in June 2024. It covered 9 clinical issues in the following 3 domains: (1) the management of common adverse reactions of BTKi such as bleeding, cardiovascular events, hematological toxicity, infections, rashes, diarrhea, and arthralgia; (2) the management of drug-drug interactions; (3) management guidance for special populations. This consensus provides evidence-based recommendations for the safety management of BTKi medication in clinical practice. This article provides an interpretation and evidence summary of the consensus in Chinese, aiming to facilitate its implementation in China, enhance the safety management of BTKi treatment, and improve patient outcomes.

BACKGROUND:Deferoxamine exhibits multiple functions such as stem cell modulation,immune regulation,and promotion of angiogenesis and osteogenesis,but its role in the osteoinhibition induced by dexamethasone in osteoblasts remains unclear.OBJECTIVE:To investigate the effects of deferoxamine on osteoblasts treated with dexamethasone through the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway and to explore its potential mechanisms of action.METHODS:The proliferation of MC3T3-E1 cells treated with various concentrations of deferoxamine for 24,48,and 72 hours was assessed using the cell counting kit-8 assay to determine the optimal intervention concentration.There were control,dexamethasone,dexamethasone plus deferoxamine 10 μmol/L,and dexamethasone plus deferoxamine 20 μmol/L groups in the experiment.Cell counting kit-8 assay and flow cytometry were employed to evaluate the effect of deferoxamine on dexamethasone-induced cell proliferation and apoptosis.Alkaline phosphatase staining and activity assays were conducted to assess alkaline phosphatase levels in MC3T3-E1 cells.Alizarin red staining was used to observe the formation of mineralized nodules.Western blot was employed to detect the expression of osteogenic and signaling proteins.RESULTS AND CONCLUSION:(1)Deferoxamine showed no significant cytotoxicity to MC3T3-E1 cells within the range of 5-20 μmol/L and could ameliorate the inhibitory effects of dexamethasone on MC3T3-E1 cell proliferation and apoptosis.(2)Compared with the dexamethasone group,deferoxamine groups increased alkaline phosphatase activity and cell mineralization,and also significantly increased the protein expression of osteopontin,runt-related transcription factor 2,and alkaline phosphatase in MC3T3-E1 cells.(3)Deferoxamine also activated the hypoxia-inducible factor 1α/vascular endothelial growth factor pathway in dexamethasone-treated MC3T3-E1 cells.To conclude,deferoxamine can alleviate apoptosis in osteoblasts induced by dexamethasone treatment,maintain the vitality of osteoblasts by activating the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway,and promote their proliferation,which may help delay the progression of steroid-induced osteonecrosis of the femoral head.